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H J Peiper

Publications and source records attributed to H J Peiper.

At least 37 records · Page 2Linked to original sources
PubMed1989

The perfused porcine pancreas as a model for testing organ protective solutions.

The present study was designed to establish an in vitro perfused porcine pancreas preparation as a model for testing the effect of organ protective solutions on stimulated pancreatic endocrine and exocrine secretion. The pancreas was prepared and perfused for 10 min with Euro Collins solution, thereafter it was stored in the cold (4 degrees C) for various times. After 3-h and 6-h ischemia pancreatic insulin release in response to glucose was not significantly affected. After 12-h ischemia reduced pancreatic insulin secretin, increased perfusion pressure, and increased amylase and lipase release indicated pancreatic damage. Complete pancreatic dysfunction was seen after 24-h and 48-h ischemia with massive increase in perfusion pressure and low insulin secretion which did not follow a glucose-dependent release pattern, while amylase and lipase concentrations in the perfusion medium increased. Stimulated exocrine pancreatic secretion was significantly decreased already after 3-h ischemia and completely lost after 12 h.

Amylases↗
PubMed1988

[Staging in non-Hodgkin's lymphomas].

In the period from 1970 to 1986, 46 patients with non-Hodgkin's lymphoma were laparotomized and splenectomized at the Surgery Division, University of Göttingen. The operation was frequently carried out in advanced or generalized stages with a therapeutic indication and served for purely diagnostic purposes in only a proportion of the cases. The Kiel classification was chosen for the histology. Accordingly, hairy-cell leukemia (14 cases) and chronic lymphatic leukemia (12 cases) were the most frequent diagnoses, followed by LP immunocytoma and centroblastic-centrocytic lymphoma (seven cases each). In four out of the 20 clinical pictures which were not already generalized by definition, i.e. in 20% of the cases, exploratory laparotomy resulted in a change of stage (comprising two improvements and two deteriorations). The spleen was affected in 41 out of the 46 patients; in addition, lymphomatous infiltrations were found in six of the 12 liver biopsies taken and in 15 out of 17 lymph node preparations taken. The average spleen weight in the NHL patients (1,623 g) was markedly higher than in a reference group of Hodgkin patients (317 g). With critical establishment of the indication, exploratory laparotomy with splenectomy in histologically verified NHL and lymphography in the clinical staging are the most precise methods of investigation in graduated diagnosis of non-Hodgkin's lymphomas.

Adult↗
PubMed1987

Surgical treatment of pancreatic pseudocysts.

Between 1966 and 1980, 54 patients (40 men and 14 women) with a mean age of 38 years were operated on for a pancreatic pseudocyst at the Department of General Surgery, University of Göttingen. The aetiology of the cysts was alcohol abuse in 35 patients, biliary diseases in 8, blunt abdominal trauma in 4, virus-induced in 2 and unknown in 5. With the exception of those who had had trauma, all patients were suffering from chronic pancreatitis. Surgical therapy included in all cases a cystojejunostomy (52 with a Roux-Y-limb and 2 with an omega loop). The mean follow-up period was 13 years (range 6 to 20 years). The late mortality was 15 per cent (8 of 52 patients). Recurrent cysts occurred in two patients (5 per cent) and relapse of pancreatitis in one third of the patients. Deterioration of carbohydrate metabolism was observed in 20 per cent of the patients. After drainage operation stool fat content became normal in 20 per cent and deteriorated in 13 per cent. Persistence or cessation of alcohol intake influenced the long-term results. From these data we conclude that both alcohol withdrawal and sufficient drainage of the pseudocyst are important factors in the prognosis of pseudocyst.

Adult↗
PubMed1987

[Staging in Hodgkin's lymphoma. Exploratory laparotomy with splenectomy].

In the present paper, 66 Studies on exploratory laparotomy with splenectomy in Hodgkin's lymphoma from Western Europe and the USA are presented in tables. This statistical compilation on 7183 laparotomies shows that the spleen was involved in 39.9% (2685 out of 6900 cases investigated), the liver in only 7.7% (446 out of 5789) and the abdominal lymph nodes were involved in 30.3% (1389 out of 4578) of the cases. Altogether, laparotomy with splenectomy led to a change in staging in 33% of the patients (1892 out of 5745). In the period from 1970 to 1986, 123 patients with Hodgkin's lymphoma were laparotomized (and also splenectomied apart from one exception) at the Surgical Division, University of Göttingen. The patients comprised 52 cases in the context of primary staging and 71 cases in the context of secondary staging. In 43 cases (35.2%) the spleen was affected, in seven cases (5.7%) the liver was affected, and there was combination with spleen involvement in each case. Infiltration of abdominal lymph nodes was shown in 38.2% (26/68). Exploratory laparotomy led to a change in stage in 46 cases (37.1%) comprising 28 improvements and 18 deteriorations. Before laparotomy, 15 patients were in stage I, 29 in stage II, 44 in stage III and 21 in stage IV. After pathological staging, 14 were in stage I, 40 were in stage II, 47 were in stage II and 19 were in stage IV. Out of the 14 patients who could not be assigned to any stage before the operation, 11 could be definitively staged afterwards. In addition, lymphography was performed in 103 patients, liver and spleen scintigraphy in 51 patients, sonography in 30 patients and computer tomography in 22 patients. In the re-examination of the lymph node situation in the retroperitoneal space, lymphography attained a specificity of 48% and a sensitivity of 71.4% with a positive prediction precision of 35.7% and a negative prediction precision of 88.8%.

Hodgkin Disease↗
PubMed1987

[Indications for appendectomy. A retrospective analysis].

This retrospective study was conducted into 1.506 patients who had been admitted to the author's hospital for suspicion of acute appendicitis, between 1971 and 1979. Indications for appendectomy were handled with generosity, and primary laparotomy was applied to 44.2 per cent of all cases. Perforated appendicitis was of low incidence, accounting for only three per cent, while no acute inflammatory lesions were recordable at all from 36 per cent of removed appendices. Follow-up checks were made on all patients who had not been operated on, in the first place, not later than five years from first diagnosis. Only 15 per cent of these patients had to be eventually appendectomised. For them distribution of histological diagnoses was similar to that of patients with surgery as primary approach. Recurrence of pain was reported by one third of patients without surgery. However, only 14.9 per cent of them saw a doctor on their problem, and only 3.7 per cent had to be rehospitalised. Primary wait-and-see attitude caused no further increase in the incidence of perforated appendicitis.

Adolescent↗
PubMed1986

[Coexistence of an extensive tubulovillous adenoma of the duodenum and a cancer of Vater's ampulla].

In the present paper we report about a patient with a large tubulo-villous duodenal adenoma associated with a carcinoma of the ampulla of Vater. Despite of lacking pre- and intraoperative evidence of malignancy a Whipple operation was performed because of extensive growth of the duodenal adenoma and its location near the ampulla of Vater. The carcinoma of the ampulla could be diagnosed only postoperatively in the resected duodenum. The problems of the presented case and the operative procedure is discussed based on a review of the literature.

Adenocarcinoma↗
PubMed1985

Significance of traumatology in abdominal and vascular surgery.

Frequency of polytrauma accounts for the numerous abdominal traumas. Abdominal injuries should be treated by an abdominal surgeon. Three hundred and seventy traumas of the abdomen were checked regarding other injuries and their percentages given. Mortality rate was 16.6 percent. The different steps of diagnosis are shown with special reference to intraperitoneal lavage and sonography. Frequency of possible organ injuries in patients at Göttingen Medical Center is noted and the special surgical care is explained. The importance and urgency of vascular injuries are discussed with reference to different types of arterial and venous injuries in the abdominal cavity and in retroperitoneal spaces.

Abdominal Injuries↗